Seasonal Influenza Vaccination Programs in the Americas: A Platform for Sustainable Life-Course Immunization and Its Role for Pandemic Preparedness and Response.

Vaccination is one of the most effective measures to prevent influenza illness and its complications. Since the 1980s, countries and territories in the Americas have progressively implemented influenza vaccination operations in high-risk priority groups-such as older adults, pregnant persons, persons with comorbidities and health workers. In this review, we present the history and progress of the seasonal influenza program in the Americas, how the program contributed to the efficient and timely roll-out of the COVID-19 vaccines during the pandemic, and how the program can be used to promote immunization operations across the life span for existing and future vaccines.

[Intentional search and reclassification of maternal deaths: quality information and its analysis to reduce maternal mortalityBusca intencional e reclassificação de mortes maternas: informação de qualidade e sua análise para reduzir a mortalidade materna].

Objective: To describe the methodology of the intentional search and reclassification of maternal deaths (BIRMM, acronym in Spanish), which allows the identification and correction of misclassification and underreporting of maternal deaths.

Methods: The BIRMM methodology, initially developed in Mexico in 2003 and disseminated in other Latin American countries since 2012, was used. BIRMM consists of four key components: i) reclassification of confirmed maternal deaths; ii) identification and investigation of suspected cases of maternal death; iii) cross-referencing with other information sources; and iv) publication of results and statistical analysis.

Development of a new definition of maternal near miss based on organ dysfunction in Latin America and the Caribbean: A prospective multicenter cohort study.

Background: There has been debate over whether the existing World Health Organization (WHO) criteria accurately represent the severity of maternal near misses.

Objective: This study assessed the diagnostic accuracy of two WHO clinical and laboratory organ dysfunction markers for determining the best cutoff values in a Latin American setting.

Methods: A prospective multicenter cohort study was conducted in five Latin American countries.

Changes in reproductive, maternal, and child health in Haiti during the pre- and peri-COVID-19 pandemic.

Objective: To assess changes in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) in Haiti from August 2018 to September 2021, before and during the COVID-19 pandemic.

Methods: A retrospective study using surveillance data from the Haitian Unique Health Information System, examining two periods: pre- and peri-COVID-19 pandemic. Health indicators at the national level in the two periods were compared using two-sample -tests for proportions, and average absolute monthly changes were calculated using variance-weighted regression.

Third stage of labor: evidence-based practice for prevention of adverse maternal and neonatal outcomes.

The third stage of labor is defined as the time period between delivery of the fetus through delivery of the placenta. During a normal third stage, uterine contractions lead to separation and expulsion of the placenta from the uterus. Postpartum hemorrhage is a relatively common complication of the third stage of labor.

Digital health and the promise of equity in maternity care: A mixed methods multi-country assessment on the use of information and communication technologies in healthcare facilities in Latin America and the Caribbean.

Introduction: Timely access to maternity care is critical to saving lives. Digital health may serve to bridge the care chasm and advance health equity. Conducted in the aftermath of the COVID-19 pandemic, this cross-sectional mixed-methods study assessed the use of information and communication technologies (ICTs) in healthcare facilities in nine Latin American and Caribbean countries to understand the landscape of ICT use in maternity care and the barriers and facilitators to its adoption.

Description of maternal and neonatal adverse events in pregnant people immunised with COVID-19 vaccines during pregnancy in the CLAP NETWORK of sentinel sites. Nested case-control analysis of the immunization-associated risk: A study protocol.

Introduction: COVID-19 is associated with higher morbimortality in pregnant people compared with non-pregnant people. At present, the benefits of maternal immunisation are considered to outweigh the risks, and therefore, vaccination is recommended during pregnancy. However, additional information is needed on the safety of the vaccines in this population.

The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system.

Objective: To determine stillbirth ratio and its association with maternal, perinatal, and delivery characteristics, as well as geographic differences in Latin American countries (LAC).

Methods: We analysed data from the Perinatal Information System of the Latin American Center for Perinatology and Human Development (CLAP) between January 2018 and June 2021 in 8 health facilities from five LAC countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic). Maternal, pregnancy, and delivery characteristics, in addition to pregnancy outcomes were reported.

Neonatal outcomes according to different degrees of maternal morbidity: cross-sectional evidence from the Perinatal Information System (SIP) of the CLAP network.

Background: The burden of maternal morbidity in neonatal outcomes can vary with the adequacy of healthcare provision and tool implementation to improve monitoring. Such information is lacking in Latin American countries, where the decrease in severe maternal morbidity and maternal death remains challenging.

Objectives: To determine neonatal outcomes according to maternal characteristics, including different degrees of maternal morbidity in Latin American health facilities.

Surveillance of severe maternal morbidity and maternal mortality in maternity hospitals of the Latin American and Caribbean network - Red CLAP: study protocol.

The sustained reduction in maternal mortality in America underlines the need to analyse women who survived a complication that could have been fatal if appropriate and timely care had not been taken. Analysis of maternal near-miss (MNM) cases, as well as potentially life-threatening conditions (PLTC), are considered indicators for monitoring the quality of maternal care. The specific objective of this study protocol is to develop a surveillance system for PLTC, MNM and maternal mortality, as primary outcomes, in Latin American and Caribbean maternal healthcare institutions.

The impact of maternal morbidity on cesarean section rates: exploring a Latin American network of sentinel facilities using the Robson's Ten Group Classification System.

Background: Latin America has the highest Cesarean Section Rates (CSR) in the world. Robson's Ten Group Classification System (RTGCS) was developed to enable understanding the CSR in different groups of women, classified according to obstetric characteristics into one of ten groups. The size of each CS group may provide helpful data on quality of care in a determined region or setting.

Scenarios of maternal mortality reduction by 2030 in the Americas: insights from its tempo.

Background: The enduring threat of maternal mortality to health worldwide and in the Americas has been recognized in the global and regional agendas and their targets to 2030. To inform the direction and amount of effort needed to meet those targets, a set of equity-sensitive regional scenarios of maternal mortality ratio (MMR) reduction based on its tempo or speed of change from baseline year 2015 was developed.

Methods: Regional scenarios by 2030 were defined according to: i) the MMR average annual rate of reduction (AARR) needed to meet the global (70 per 100,000) or regional (30 per 100,000) targets and, ii) the horizontal (proportional) or vertical (progressive) equity criterion applied to the cross-country AARR distribution (i.

From global recommendations to (in)action: A scoping review of the coverage of companion of choice for women during labour and birth.

Women greatly value and benefit from the presence of someone they trust to support them throughout labour and childbirth ('labour companion of choice'). Labour companionship improves maternal and perinatal outcomes, including enhancing physiological labour and birth experiences. Despite clear benefits, implementation is slow.

Predicting severe maternal outcomes in a network of sentinel sites in Latin-American countries.

Objective: This study aimed to determine incidences of potentially life-threatening conditions (PLTC), maternal near misses (MNM), and maternal deaths (MD) in women who gave birth in participating facilities, and to determine the probability that a pregnancy involving a PLTC would evolve into an MNM and/or an MD.

Methods: This was a multicentric observational study implemented on a maternal network from August 2018 to May 2019 in five Latin-American countries. We summarized categorical variables as frequencies and continuous variables with median, interquartile range, and standard deviations.

Cesarean section in Uruguay from 2008 to 2018: country analysis based on the Robson classification. An observational study.

Background: The use of caesarean section has steadily increased, with Latin America being the region with the highest rates. Multiple factors account for that increase and the Robson classification is appropriate to compare determinants at the clinical level for caesarean section rates over time. The purpose of this study is to describe the evolution of caesarean section rates by Robson groups in Uruguay from 2008 to 2018 using a country level database.

Diagnostic performance of two different maternal near-miss approaches in a High Obstetric Risk Unit.

Maternal near-miss (MNM) is a maternal quality care indicator. The World Health Organization (WHO) defines it as a state in which a woman nearly dies but survives due to a complication during pregnancy, birth, or puerperium. The Latin American Federation of Obstetrics and Gynecology (FLASOG) and the Colombian National Health Institute (INS) established recommendations for the event's epidemiological surveillance; nonetheless, the operational definitions of the cases are different.

Differences in maternal group B Streptococcus screening rates in Latin American countries.

Objective: To determine rates and results of maternal Group B streptococcus (GBS) screening during pregnancy and identify sociodemographic characteristics associated with GBS screening in Latin American countries.

Background: GBS is a primary cause of morbidity and mortality in neonates and is prevented by screening pregnant women for GBS before delivery and intrapartum antibiotic treatment. Yet, data regarding national GBS screening practices and the epidemiology of maternal GBS colonization in Latin America are limited.

Adverse events associated with the use of recommended vaccines during pregnancy: An overview of systematic reviews.

Introduction: Maternal immunization is aimed at reducing morbidity and mortality in pregnant women and their newborns. Updated evidence synthesis of maternal-fetal outcomes is constantly needed to ensure that the risk-benefit of vaccination during pregnancy remains positive.

Methods: An overview of systematic reviews (OoSRs) was performed.

COVID-19 and newborn health: systematic review.

Objective: To describe perinatal and neonatal outcomes in newborns exposed to SARS-CoV-2.

Methods: A systematic review was conducted by searching PubMed Central, LILACS, and Google Scholar using the keywords 'covid ' AND 'newborn' OR 'child' OR 'infant,' on 18 March 2020, and again on 17 April 2020. One researcher conducted the search and extracted data on demographics, maternal outcomes, diagnostic tests, imaging, and neonatal outcomes.

Status of national policy on companion of choice at birth in Latin America and the Caribbean: Gaps and challenges.

The World Health Organization (WHO) recommends a companion of choice during labor and birth, to improve maternal and perinatal outcomes and women's satisfaction with health services. To better understand the status of companion of choice in Latin America and the Caribbean (LAC), an online survey was conducted with members of a midwifery virtual community of practice and with key informants, aiming to identify: 1) existing regulatory instruments related to companion of choice in the countries where the members are practicing; and, 2) key characteristics of implementation of companion of choice, where regulation exists. Responses ( = 112) were received from representatives of 20 of the 43 countries of LAC.

A systematic review and meta-analysis of cesarean delivery and other uterine surgery as risk factors for placenta accreta.

Background: The incidence of placenta accreta has increased in recent years and it has been suggested that the rising trend in cesarean delivery and other uterine surgery is the underlying cause.

Objective: To explore the magnitude of the effect of performing single and repeat cesarean deliveries or other uterine surgery on the incidence of placenta accreta.

Search Strategy: Relevant databases were searched for papers published before August 1, 2018, using terms including "accreta" and "cesarean.